3. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 3
This research would not have been achieved without the infectious enthusiasm,
unwavering support and valuable technical guidance from Kate Cotton
(Volunteering Development Adviser for Southern Africa) and Clive Ingleby
(Programme Development Adviser for Health). Thank you for the massive
confidence you both have entrusted me with on this job!
Liz Holmes (VSO Regional Director for Southern Africa) for making this happen,
helping us get other programmes’ involvement in the process and for your
remarkable inputs on the draft report.
Malou Juanito (VSO Bahaginan Director) for your mentoring and generosity in
hosting me in your office and providing me with administrative support through
the Bahaginan Team.
Dixon Ngwende (VSO Malawi Country Director) for hosting my Malawi
vsit and offering your staff to assist me with my visa and administrative needs.
Thank you, too, for giving me the opportunity to share the outcomes of my field
visits with your team and expressing interest to explore the Malawi projects
further for your programmes.
Dorothy Flatman (Former Programme Development Adviser for Health) for
directing me to the right case studies and linking me up with your brilliant
contacts in Malawi.
Marco Malto for being my volunteer research assistant and for sharing my
passion for volunteering.
My sincerest gratitude to the programme staff, VSO and local volunteers of the
featured case studies: Isabelita Gravides (Barangay Health Workers); Lina
Bacalando and Maridel Icatlo (MOTHERS); Ma Lourdes de la Rea (Ugnayan ng
Pahinungód-Manila); Glenn Benablo and Amar Pureviin (VSO Mongolia); Eric
Tsetekani (The Health Foundation Consortium); Mikey Rosato and Sonia Lewycka
(MaiMwana Project), and all other NV and Health Programme Managers, for your
time, wisdom and insightful research information.
To all you other staff, community leaders and volunteers who welcomed me in
your offices, villages and homes, I have not forgotten your names or your faces –
thank you very much! Through this research, VSO hopes to spread the word on
your excellent work and inspire more people to follow your lead.
ABBY MERCADO*
RESEARCHER-WRITER
*Abby Mercado has served as NV Programme Manager under HR Solutions
Namibia in 2007, upon completing the VSO Namibia NV Feasibility Study and
Strategic Plan as VSO volunteer in 2006. She was also a member of VSO
Bahaginan from 2003-2005 in various capacities. Prior to her VSO posts, Abby
managed a national volunteering programme in the Philippines for five years.
ACKNOWLEDGEMENTS
4. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 4
AIDS ACQUIRED IMMUNE DEFICIENCY SYNDROME
BHW BARANGAY HEALTH WORKER
CORP COMMUNITY-OWNED RESOURCE PERSONS
CSP COUNTRY STRATEGIC PLAN
DOH DEPARTMENT OF HEALTH
ERVP EMERGENCY ROOM VOLUNTEER PROGRAMME
FCHW FAMILY CLINIC HEALTH WORKERS
ICRC INTERNATIONAL COMMITTEE OF THE RED CROSS
ICT IN-COUNTRY TRAINING
IDP INTERNALLY DISPLACED PEOPLE
HIV HUMAN IMMUNODEFICIENCY VIRUS
HSA HEALTH SURVEILLANCE ASSISTANTS
LTV LONG-TERM VOLUNTEERING
M&E MONITORING AND EVALUATION
MOTHERS MOTHERS’ ORGANISATION FOR TOTAL HEALTH EDUCATION,
RESEARCH AND SERVICES
NGO NON-GOVERNMENTAL ORGANISATION
NV NATIONAL VOLUNTEERING
PAP PROGRAMME AREA PLAN
PGH PHILIPPINE GENERAL HOSPITAL
PMTCT PREVENTION OF MOTHER-TO-CHILD TRANSMISSION (OF HIV)
PO PROGRAMME OFFICE
QI QUALITY IMPROVEMENT
RA REPUBLIC ACT
STV SHORT-TERM VOLUNTEERING
SWGS SENIOR WOMEN’S GROUPS SUPERVISOR
TB TUBERCULOSIS
TBA TRADITIONAL BIRTH ATTENDANT
THFC THE HEALTH FOUNDATION CONSORTIUM
UN UNITED NATIONS
UNICEF UNITED NATIONS INTERNATIONAL CHILDREN'S
EMERGENCY FUND
UP UNIVERSITY OF THE PHILIPPINES
VHT VILLAGE HEALTH TEAMS
VMC VOLUNTEER MAIMWANA COUNSELLORS
VSO VOLUNTARY SERVICE OVERSEAS
WG WOMEN’S GROUPS
LIST OF ACRONYMS
5. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 5
The global reality of a lack of international health care professional volunteers
and VSO’s increasing emphasis on national volunteering present the ideal
opportunity to explore the role that local volunteers can play in responding to
health care challenges. Through national, local or community volunteering,
human resources that can be tapped to address massive health challenges are
not limited to medical or health professionals. While health volunteering
initiatives often encourage medical and health professionals to share their skills
as volunteers, it also opens doors to non-medical or health related groups or
individuals to do their share in promoting good health and health care services in
their own communities or countries, in their own way.
VSO programme offices and federation members worldwide now face the
challenging task of delivering on VSO’s corporate priorities to increase the impact
of VSO’s work in the areas of health and national volunteering. Local Volunteering
Responses to Health Challenges aims to serve as a useful reference for
programme offices in exploring ways to scale up VSO’s work in health through
national volunteering.
The MaiMwana Project and The Health Foundation Consortium illustrate how
Malawian women volunteers are taking charge of maternal and child health
issues in their own villages. VSO Mongolia’s NV Programme, which started two
years ago with one NV partner, is now supporting four health districts in
managing their local health volunteer programmes, with assistance from VSO
volunteers. In the Philippines, UP’s Ugnayan ng Pahinungód-Manila proves that a
university’s resources can be tapped through volunteering in order to serve the
health needs of Filipinos in remote areas. Filipino mothers advocating for
women’s rights to health care and providing reproductive health care services are
featured in Likhaan’s MOTHERS. Finally, the case of the Barangay Health Workers
demonstrates how local volunteers’ vital role in promoting health in the
communities has earned them legislation to support their remarkable volunteer
contribution in the Philippines. Whether through counselling new mothers on
breastfeeding, advising couples on family planning, lobbying for women’s rights to
health care, giving patients that ‘human factor’, conducting puppet shows on
healthy lifestyle, or facilitating women’s groups to mobilise communities, the case
studies in this report prove that health volunteering is already happening in
different countries and in various settings – villages, hospitals, health centres and
academia.
The case studies of health volunteer programmes gathered from Malawi,
Mongolia and the Philippines demonstrate the potential and the opportunities for
involving volunteers in delivering high quality health services. There is clear
evidence that volunteers can contribute to assisting countries to deliver their
national health plans and priorities.
EXECUTIVE SUMMARY
6. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 6
The research has identified the following key issues that programmes may
need to consider when planning, implementing or scaling up national
volunteering in health:
• the need for political will and strong partnerships with the Ministry of Health
• ensuring that volunteer roles complement the work of qualified health
professionals
• the key role of community leaders in ensuring appropriate and sustainable
volunteer health programmes
• paying attention to and prioritising gender considerations
• recognising and mitigating the specific risks faced by health volunteers
• developing health specific resources to support health volunteers and
their managers.
This report concludes with a set of considerations for VSO programme managers
who are planning to initiate or scale up national volunteering in health. These
include the need for maximising opportunities presented by VSO’s ‘tool box’, the
critical role of planning and review, the potential for corporate partnerships and
advice around how to replicate successful NV health programmes. By presenting
realistic and effective examples of how local or community volunteering activities
within VSO and non-VSO health programmes are uniquely responding to health
care issues, this research report hopes to inspire VSO programmes to develop
their own NV thinking within the VSO Health Goal.
7. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 7
VSO’s consistently innovative work in volunteer programming has enabled us to
respond to the evolving challenges of poverty. VSO constantly develops creative
approaches to provide appropriate assistance where it is most needed, when the
time is right. Among its recent innovations has been the decision to support
national volunteering (NV). National volunteering builds on VSO’s distinctive
competence based on its rich history and experience in working with volunteers.
It also offers a more contemporary approach to volunteering by making use of a
country’s most valuable resource – its people.
The global reality of a lack of international health care professional volunteers
and VSO’s increasing emphasis on national volunteering present the ideal
opportunity to explore the role that local volunteers can play in responding to
health care challenges. NV has the potential to create a significant impact on
health care provision in a cost effective way. Most of the countries that are
suffering from a chronic shortage of skilled health workers are the same ones
suffering from the greatest public health threats.1
Through national, local or
community volunteering, human resources that can be tapped to address massive
health challenges are not limited to medical or health professionals. While health
volunteering initiatives often encourage medical and health professionals to
share their skills as volunteers, it also opens doors to non-medical or health
related groups or individuals to do their share in promoting good health and
health care services in their own communities or countries, in their own way.
The VSO National Volunteering Guide for Programme Offices clarifies what is
included as volunteering, namely, community and national, full and part-time
activity that is structured and/or formalised and:
• is undertaken for the benefit of the wider community beyond the volunteer’s
immediate family and friends
• is undertaken by choice and free will
• the volunteer’s motivation will not be for financial gain
• that rather than any specific model of volunteering, VSO will focus support
where sustained commitment is demonstrated
• the volunteers define themselves as such.
VSO programme offices and federation members worldwide are now challenged
with responding to VSO’s corporate mandate to increase the impact of VSO’s work
in the areas of health and national volunteering. This research showcases how
the call to improve VSO’s work in health and in national volunteering could be
addressed simultaneously through one course of action – promoting national
volunteering initiatives in the health sector. The case studies in this report feature
how health volunteering is already happening in various countries, by providing
VSO programmes with the opportunity to think of what further opportunities may
exist within their respective environments. By presenting realistic and effective
examples of how local or community volunteering activities within VSO and non-
VSO health programmes are uniquely responding to health issues, this research
report hopes to inspire VSO programmes to develop their own NV thinking within
the VSO Health Goal.
INTRODUCTION
1 Strategic Position Paper
for VSO’s Health Goal,
January 2007.
8. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 8
The priority areas for purposes of this research are:
• maternal, newborn and child health (e.g. pre and post natal care, safe delivery,
early years care, etc…)
• sexual and reproductive health (e.g. life skills training to youth, condom
promotion and other family planning, HIV and AIDS/STI awareness, tackling
violence against women and gender inequity, etc…)
• health promotion messaging (e.g. nutrition, water and sanitation, inoculation,
malaria prevention, etc…)
• advocating for rights to access health care.
Volunteering in these health areas happens at different levels – community,
health care settings, primary to tertiary level hospitals, government units and
academia. This research explores the various settings wherein health
volunteering takes place.
Through offering examples of how VSO and other organisations are supporting
the mobilisation of national volunteers to complement existing health service
delivery, synthesising lessons from the case studies and outlining recommen-
dations for VSO programmes, this research aims to serve as a useful tool in:
• providing further thinking to programmes already implementing national
volunteering in support of the health goal, on how to scale up their work
• supporting, encouraging and inspiring existing VSO health programmes not
currently including national volunteering within their work to consider
developing a national volunteering component
• encouraging those programmes considering developing a programme
area plan (PAP) on health to include national volunteering as part of
programme development.
9. HEALTH
FOCUS
VOLUNTEERING
ACTIVITIES
VOLUNTEERS RESOURCES/
LINKS
COUNTRY/ORG/
PROGRAMME
LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 9
HEALTH
PROMOTION
HEALTH
PROMOTION
HEALTH
PROMOTION
MATERNAL
AND CHILD
HEALTH
MATERNAL
AND CHILD
HEALTH
SEXUAL AND
REPRODUCT-
IVE HEALTH
ADVOCACY
FOR RIGHTS
TO ACCESS
HEALTH
CARE
Philippines:
University
of the
Philippines
Ugnayan ng
Pahinungód
Mongolia:
VSO Mongolia
Philippines:
Barangay
Health
Workers
Malawi:
MaiMwana
Project
Malawi:
The Health
Foundation
Consortium
Philippines:
Likhaan
(Linangan ng
Kababaihan)
MOTHERS
• Conducting health education
and trainings
• Conducting health medical and
surgical missions
• Providing emergency care
• Health counselling
• Monitoring of blood pressure
and vital signs
• Promoting healthy lifestyle
• Therapeutic massage
• Promoting traditional medicine
• Providing primary health care
(with supervision from medical
doctor and nutritionists)
• Disseminating family planning
information through seminars
and counselling
• Surveying of community health
baseline data
• Promoting essential newborn
care and safe motherhood
• Breastfeeding counselling
among new mothers
• Disseminating information on
nutrition and hygiene
• Facilitating women’s groups to
mobilise and prioritise local
health needs
• Promoting use of health
facilities
• Disseminating information on
nutrition and hygiene
• Providing primary and
reproductive health care
(family planning) services
• Lobbying for women’s rights to
health care
• Conducting health education
and trainings
Medical and health
related students,
graduates, alumni,
faculty and staff
Community
members
(non-health/medical
professionals)
Community
members (mothers/
women,
fathers/men, non-
health/medical
professionals)
Women of
reproductive
age/mothers from
benefiting
communities
Women of
reproductive
age/mothers from
benefiting
communities
Community
members
(mothers/women,
fathers/men, youth,
non-health/medical
professionals)
www.pahinungod.org
publications
(newsletters,
volunteer and
technical journals,
annual reports)
NV Impact
Assessment
Proceedings
Mongolia Study Tour
Report
Complete version of
Philippines Republic
Act 7883: Barangay
Health Workers'
Benefit and
Incentives Act
of 1995
MaiMwana Project
Protocol and
Brochure
www.wcf-uk.org
The Health
Foundation
Consortium Monthly
Reports and Project
Presentations
Field study reports
http://en.wikipedia.
org/wiki/Likhaan
SUMMARY OF CASE STUDIES
10. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 10
PHILIPPINES ON HEALTH PROMOTION
University volunteers promoting health in the
communities and responding to emergency care
Inadequate facilities, unequal distribution of available
medical services and supplies, and the high cost of
health care prevent many Filipinos from getting the
medical attention they need. Their remote geographic
location, on the other hand, prevents them from
accessing proper health care and information. In a
country of more than 7,100 islands with scattered
mountains and insufficient road networks, any
available services shrink further because of physical
access difficulties. Ugnayan ng Pahinungód-Manila has responded through
medical and surgical missions accompanied by health education and trainings,
delivered in the most isolated and disadvantaged communities in the
Philippines; and an Emergency Room Volunteer Programme for the poorest
Filipinos in the capital city.
Learning through service
As a state university student, it is not enough to get high grades or do well in
academic study. One is also expected to be socially responsible and prove worthy
of the taxpayers’ money. In 1993, a study of knowledge, attitudes and values
showed that University of The Philippines (UP) students and faculty were not as
socially committed as the university had thought. On 28 February 1994, the
Ugnayan ng Pahinungód was officially launched as the University of the
Philippines’ (UP) Volunteer Service Programme “to make the University a more
caring academic institution that is bound together by a commitment to the
empowerment of people and selfless service to the nation”. Dr Carmencita
Padilla, one of the pioneering directors of Ugnayan ng Pahinungód-Manila,
explained, “It is the University’s responsibility to enrich the lives of our students,
faculty and personnel through opportunities where they can give ‘part of
themselves’ to our people. With children spending more time in school and with
all the negative distractions in society, there must be a conscious effort by both
family and the University to enrich the lives of students through experiential
learning beyond the walls of the [classroom].”
The University of the Philippines is comprised of seven constituent universities –
each is known for its field of specialisation. The Pahinungód unit in each of these
UP campuses developed its own set of volunteer activities by building on the
available skills of its constituents, as well as on what individuals and
organisations within the campus have already started. The UP Manila, being the
nerve centre of studies in medicine and its allied professions, has medical
students, professionals, alumni, and even equipment, within reach, thus inspiring
Pahinungód-Manila to develop a health programme.
More than your regular health mission
In the Philippines, health missions are often viewed as unsustainable. Ma Lourdes
de la Rea, Pahinungód-Manila’s Health Programme Manager, sees them as the
means to provide opportunities to dig deeper into the community’s health issues.
The Pahinungód health teams give direct health and medical care through the
missions. As a result of the health education and training provided by Pahinungód,
they build the skills of community-based medical professionals, who are brought
CASE STUDIES
11. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 11
up to date on the latest methods relevant to their specialisations. In addition, they
train community health volunteers, who feel more confident in promoting proper
nutrition and good health practices to prevent diseases in their areas.
“I do not panic any more each time my children get sick because I now have better
understanding of common illnesses and I even know ways to prevent them. Within
my community, people come to me because they now recognise me as a trained
community health volunteer. I feel that I am able to contribute to my community.
Even though I did not finish my education, I have my health training that I can use
for the rest of my life, and even share with other members of my community.”
Rosalinda Manuntag, one of the volunteer health workers and a mother, shares
the benefits of attending Pahinungód health trainings.
Emergency volunteering
The Emergency Room Volunteer Programme (ERVP) was started by Pahinungód-
Manila in partnership with the Philippine General Hospital’s (PGH) Department of
Emergency Medical Services, to address the government hospital’s shortage of
personnel, while providing yet another opportunity for the UP Manila students to
do their share, without having to go to the remotest areas of the country where
the health missions and trainings happen. The PGH Emergency Room
accommodates about 250-300 poor patients seeking emergency care every day.
All ER volunteers must go through orientation and corresponding pre-deployment
trainings on four different levels: level 1 trains volunteers to become ER Relations
Officers; level 2 is for First Aid Workers; level 3 is for Trauma Care Providers; and
level 4 is for Ambulance Team Volunteers.
“The ERVP was originally established to address our lack of staff, but now with
more available personnel, the ER volunteers give our patients the ‘human factor’
that ER staff rarely have the time to spare,” said Dr. Ma Lourdes Jimenez who is
now on her extension year as ER Chief Resident having been inspired by her
involvement in the UP’s volunteer programme. “With the rise of the Philippine’s
medical tourism, most Filipino doctors and nurses cannot wait to work overseas
as soon as they pass the medical board exam. Since I am responsible for the pre-
deployment orientation of the ER volunteers, I feel that my most valuable
contribution is when I try to make the volunteers realise how much they are
needed in their own country.” Dr Ma Lourdes shares her personal advocacy.
Regina Francisco, an ER volunteer and a nursing graduate, started volunteering
at PGH’s ER in 2006. Just like many Filipino nursing graduates, Regina was
planning to work abroad once she passed the board exam. That was before her
ER volunteering. Today, Regina has promised to stay and serve as a nurse in her
own country, where she realised she is also needed. She also continues with her
ER volunteering to enhance her skills while being of service to disadvantaged
Filipino patients.
12. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 12
Working with volunteers
“Volunteers have different attitudes and part of my job is learning how to deal with
their diverse characters to have an effective working relationship with them,”
Health Programme Manager Ma Lourdes confesses one of the main challenges
she encounters at Pahinungód. Meanwhile, the ER Chief Resident mentions how
the volunteers’ motivations vary, hence the importance of appropriate orientation
before deployment followed up with regular supervision.
Different promotion strategies are implemented to target students,
alumni, personnel and funding supporters. Staff and volunteers conduct room-to-
room campaigns to announce upcoming orientations, supported by posters and
flyers distributed around the campus. Participants are given application forms at
the end of orientations for volunteers to complete, depending on whether
any of the programmes interest them. Given the wide array of volunteering
activities that Pahinungód has to offer, almost every participant would find one
that matches their interests and skills. Part of the orientation is guiding the
participants in choosing the volunteer programme that suits their availability,
skills and interests.
Selection in the Ugnayan ng Pahinungód occurs at two levels: volunteer selection;
and selection of partner institutions. The careful matching of volunteers with
organisations not only improves volunteer motivation but also organisational
performance. Initially, one has to be affiliated with the University of the
Philippines in any capacity to be a Pahinungód or volunteer. Recently though, some
programmes have been opened to accommodate non-UP volunteers, such as the
ERVP, as long as they have the proper motivation and needed skills. Volunteers
are oriented about the Ugnayan ng Pahinungód’s goals and objectives so they can
put in perspective their own goals and objectives. Every volunteer is required to
undergo pre-deployment trainings, including onsite visits to demonstrate
appropriate behaviour and dress in the field, and other relevant briefings deemed
crucial for their new volunteer roles.
Ugnayan ng Pahinungód has a creative way of nurturing its volunteers. Apart from
weekly meetings and discussions after each volunteer activity, gatherings among
different Pahinungód programmes are held at least twice a year to provide
avenues for volunteers to share and reflect on their experiences. Volunteers
prepare creative presentations to illustrate their volunteering roles, the highlights
and the challenges they face in the field. It is also during these Pahinungód
assemblies that special awards of simple tokens (i.e. Pahinungód shirts and
publications, paper weight, school supplies…) are accorded to all volunteers, as
programme managers always find a special attribute in each of their volunteers
that would merit an honourable distinction.
Programme managers also conduct regular site visits to monitor the work of their
volunteers, and to provide individual consultations or debriefings with volunteers,
as needed. Furthermore, every volunteer is encouraged to write a reflection
paper, which is another opportunity for volunteers to express their sentiments
and process the impact of the work they do within themselves and among their
beneficiaries. These reflections are often a rich resource for Pahinungód’s
promotion materials.
13. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 13
Promoting the spirit of volunteerism
Ugnayan ng Pahinungód-Manila’s volunteering does not end in actual service. It
is also an advocate for volunteering using its website, quarterly newsletter and
series of inspiring publications to encourage others to get involved. It holds
regular events to recruit more volunteers or raise funds, and most importantly to
give recognition to the Pahinungóds. Through the Ugnayan ng Pahinungód, UP has
not only enthused non-UP constituents to volunteer with Pahinungód-Manila, but
has also inspired several other academic institutions to develop their own
volunteer programmes.
MONGOLIA ON HEALTH PROMOTION
VSO volunteers working with health departments,
supporting Mongolian volunteers
When was the last time you went see a puppet show to find out about
how to treat your common ailments? The idea may seem unusual, but in
Mongolia this novel approach to informing people about how to look
after their health is significantly reducing the pressure on the country’s
doctors and nurses.
Glenn Benablo is a VSO volunteer working at the Darkhan Health Department and
he is supporting groups of Mongolian volunteers who work with communities
around the Darkhan area. Like many poor countries Mongolia suffers from
insufficient equipment, a lack of qualified personnel and huge discrepancies in
health care availability between rural and urban areas. Aggravating this is the
tendency for Mongolians to bypass their local GP and head straight to hospital.
Those that do attempt to use their local clinics often find that nurses are out
visiting patients who are too sick to travel.
National volunteering is a familiar concept in Mongolia and The Health District did
already have a number of volunteers registered, but they were not training them
so consequently the volunteers were ineffective and received little respect from
the communities. As a community nurse trainer, Glenn is working to improve the
status of these volunteers and the service they offer. The first step was to rename
the volunteers as Family Clinic Health Workers (FCHW), provide them with a
uniform, and train them to undertake basic tasks, such as routine health checks
and blood pressure tests.
One of their most important roles is to raise awareness of how people can take
better care of themselves to prevent illness. To help this, Glenn organised a study
tour to the Philippines, where staff from the Health Department and the Family
Clinic Health Workers saw how community volunteers successfully work in his
home country and how puppetry can be used to communicate sensitive health
care lessons. On their return to Mongolia the volunteers created a puppet show
and video about the need for vaccinations.
All of this happened within a year of Glenn arriving in volunteer. As a result of this
NV support and the funded tour, the Director of the Health Department has
provided an allowance of $5 a month for the Family Clinic Health Workers and
doctors and nurses have reported that they are able to spend more time treating
people in the clinics.
14. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 14
Two years hence
Glenn is about to finish his two-year volunteer placement in Mongolia and he
wanted to know whether his work on national volunteering has indeed made an
impact on the VSO partner, the Family Clinic Health Workers and most
importantly, on the health of the people in Darkhan Uul.
He conducted an Impact Assessment Study to identify areas of strengths and
improvement, as well as the sustainability factors for the Darkhan Health
Department’s NV initiative. The study sought to gather feedback from
stakeholders in the following areas; service access, quality of health services
supplied by volunteers, increase in the health knowledge of patients, communi-
cation skills of volunteers and levels of community trust in their work, as well as
the quality of health training provided to the health volunteers. Assessing the
success of the local volunteering support at the Darkhan Health Department
would also guide VSO Mongolia in replicating this NV support among other VSO
partner organisations and agencies in the country.
The health information activities of the Family Clinic Health Workers have led to
positive changes among the people of the Darkhan District. For example, through
use of puppet shows and videos more children brush their teeth regularly, people
know more about preventable diseases, safe water and hygiene, and more
Mongolians have gained information on how to live a healthy lifestyle. The NV
Impact Assessment has shown that communities would like more local health
volunteers and to see an increase in support for their volunteering services,
through including the FCHW Project in government policies, and giving the
volunteers livelihood and training opportunities.
These encouraging outcomes, including good results of the health programme’s
delivery and high rate of health workers’ accessibility, are just a few of the
many reasons to continue and learn from what Glenn has started at the Darkhan
Health Department.
Replicating best practices
Since 2007, three other health districts in Mongolia are learning from the Darkhan
Health Department’s NV experience. The Chingletei District Health Unit, with
support from another VSO volunteer, is training its newly recruited health
volunteers on basic health issues. The government has also started to provide
Chingletei’s 40 local volunteers a small monthly stipend, beginning in 2008, which
removes some of the financial barriers to volunteering. A staff member to
supervise and work closely with the health volunteers has also been employed by
the district health unit.
Another VSO volunteer placed in the Nalaikh District Health Department is
extending their term to continue working with the district health department in
supporting its Mongolian volunteers. These health volunteers have the same
roles as Family Health Clinic Workers in Darkhan, but are not yet receiving the
same amount of support, particularly in terms of stipends.
The same NV efforts are being promoted at the Dornod Health Department,
which at this stage is still recruiting more local volunteers to set up its health
volunteer programme.
15. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 15
The staff and local volunteers of the four health districts – Darkhan,
Chingletei, Nalaikh and Dornod – are also linked to one another to provide
technical support and learn from each department’s experiences. NV partners’
exchange visits and a research on health volunteering in the country have also
been conducted to further support national volunteering initiatives within the
health sector in Mongolia.
PHILIPPINES ON SEXUAL AND REPRODUCTIVE HEALTH,
MATERNAL AND CHILD HEALTH
Barangay health workers’ frontline role in community health leads to
national legislation supporting their volunteering efforts
“A young couple with a newborn came to me in the middle of the night
because their baby would not stop crying. The baby was allergic to milk
formula. Armed only with herbal medicine training from way back, I
boiled a couple of banana leaves, added some medicine and fed the
broth to the baby. The baby instantly stopped crying and slept soundly.”
Isabelita Gravides, a barangay2
health worker (BHW) since the 1980s,
says that seeing a comforted newborn and equally relieved parents made
that incident one of her most unforgettable memories as a community
health volunteer. Isabelita says before the implementation of a government
policy on the BHW benefits and incentives, she and her fellow community health
volunteers had to rely on their own knowledge and experiences to assist the local
health centre in delivering basic health services in their community. With the
legislation, BHWs are regularly provided with trainings giving them the assurance
that they are doing the proper intervention and enabling them to be more effective
in their roles as community health volunteers.
The Philippines’ Republic Act (RA) 7883 is an Act granting benefits and incentives
to accredited barangay health workers. Since its approval on 20 February 1995,
the Department of Health (DOH), in cooperation with concerned government
agencies and non-government institutions, has formulated the rules and
regulations necessary to implement the Act. RA 7883 defines a ‘barangay health
worker’ as a person who has undergone training programmes under any
accredited government and non-government organisations, and who voluntarily
renders primary health care services in the community after having been
accredited to function as such by the local health board in accordance with the
guidelines promulgated by the DOH.3
Decentralisation of health responsibilities
Often referred to as ‘living heroes’, these barangay health workers seemed to
have let their great work be the impetus for the government to finally
acknowledge their contribution to healthier communities. Prior to the 1995
legislation, several researches on Philippine health development highlighted the
role of BHWs nationwide and made recommendations on how their valuable work
could be supported and sustained. Advocacy activities by several non-government
organisations may have also supported the enactment of the government policy.
However, Philippine history shows that the government itself, in aid of its ongoing
devolution of national power to local authorities, initiated the legislation.
The 1991 Local Government Code provided that health offices from provincial to
the smallest political unit become the responsibilities of local governments. To
improve the delivery of health and family planning services, the DOH has
instituted a health volunteer programme, and barangay health workers have been
2 A barangay is the smallest
political unit in the
Philippines. The barangay
system aims to broaden
the base of citizen
participation in the
democratic process and to
afford ample opportunities
for the citizenry to express
their views on important
national issues. Being a
small, closely and
interpersonally related
group, the barangay
hopes to draw out more
responsive opinions, ideas
and involvement from its
members. As such, its
main goal is to be service-
and development-
oriented.
3 Republic of the
Philippines’ Department
of Health, Republic Act
7883: Barangay Health
Workers Benefits and
Incentives Act of 1995.
16. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 16
assigned to serve as the immediate link between the community and health
centres. Activating the BHWs as frontliners of health care in the communities
then became one of the top priorities of the Department of Health. Since the
government cannot employ the BHWs outright due to other restrictions, the DOH
sought out other benefits within its realm of authority through the RA 7883.
A defining moment
What made the Department of Health’s OPLAN Alis Disease4
the most ambitious
yet successful vaccination campaign in world history, attracting foreign
spectators, such as Hillary Clinton and other famous UN personalities to visit the
Philippines and learn from it? It delivered all vaccines in all parts of the country
from 1993-1995 using participatory planning and implementation from different
sectors. There was no way the government health workers consisting of doctors,
midwives, nurses and staff would have achieved what they did during the three-
year campaign had not every barangay health worker tirelessly knocked at the
doors of 15 to 25 households, even in the farthest areas of the country.
“I lost two babies to miscarriage before I finally sought assistance from our
barangay health workers to guide me in my pregnancies. Today, I have five
children and each of them has been delivered safely because my BHW has kept a
close watch at my pregnancies, often involving my husband. From family
planning, birth spacing, to the immunisation and proper nutrition of my children,
I have been reliant on the information and advice provided by the BHWs in our
community.” Loida Boco admitted that her lack of sufficient knowledge during her
first pregnancies had been the cause of her miscarriages – an occurrence that
every barangay health worker tries to prevent from happening through
appropriate health information and timely intervention.
The remarkable contributions of the BHWs in executing government health
campaigns have made it particularly easy for the Congress to pass the bill on the
volunteers’ incentives and benefits.
Fifty-three-year-old Flory Nose has been serving as a BHW for 20 years. The
fulfilment she gains from her community involvement has led her to committing
her Mondays to Fridays, checking dish racks of each household in her assigned
street of at least 250 families, as part of their anti-mosquito campaign; doing a
headcount of women of reproductive age; offering family planning
information to new couples; guiding pregnant women on proper diet and lifestyle
for safe pregnancy and birth delivery; and once the child is born, Flory also visits
the newborn to check what vaccines and vitamins have been provided by the
doctors. These are just a few of the many and expanding roles that most
barangay health workers all over the Philippines fulfil. Flory also noted the
increase in frequency of health seminars in the 1990s, provided by both
government and non-government institutions. She also began receiving a
monthly volunteer allowance of P1000 (about $25), which covers her transport,
reporting and other field expenses.
The Section 6 or Incentives and Benefits of RA 7883 states, “In recognition
of their services, all accredited barangay health workers who are actively and
regularly performing their duties shall be entitled to: hazard allowance;
subsistence allowance; educational and training programs, continuing education,
study tours and scholarship benefits; among many other accreditation and free
government services.”
4 OPLAN stands for
Operations Plan, while
Alis means to eradicate.
17. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 17
Caring for carers
The implementation of RA 7883, however, proved to be more challenging than its
enactment because it involved money and other resources to be redistributed
among local governments. BHW Isabelita, now a barangay captain5
, looks after
the plight of her barangay health workers by allocating enough funding within her
limited budget to support their work. Her higher office has not been granted the
requested budget so she could provide her 15 barangay health workers all the
incentives and benefits defined in the Act. Together with a government doctor and
two nutritionists, these BHWs serve the primary health needs of a constituency of
35,000. To augment funding for their activities, they organise cake raffles, bingo
and other fundraising activities.
Having been volunteering even before the RA 7883 was passed, BHWs are
motivated by goodwill. They added, however, that the Act proves how their
contribution is being recognised not only by the people in their communities, but
also by the national government.
The Philippine President Gloria Macapagal-Arroyo has recently granted an
additional budget for the health insurance subsidy of barangay health workers
nationwide, saying, “Because you take care of the health of the people in the
community, the government will take care of your health”.
With the high cost of health care in the Philippines, the barangay health workers
are comforted by this additional government incentive and can confidently
continue to look after the health of their fellow Filipinos knowing that they, too,
have health insurance protection that they duly deserve.
MALAWI ON MATERNAL AND CHILD HEALTH
Volunteer MaiMwana Counsellors promote essential
newborn care and safe motherhood
Sixty-three per cent of children in Malawi under four
months are exclusively breastfed, but this drops off to only
12 per cent when the children reach four to five months of
age. In a country where the estimated HIV prevalence
among women between 15 and 49 years is approximately 17.5 per cent, HIV
and AIDS prevention should be an integral part of any maternal and child health
interventions. Children born to HIV positive mothers have a higher risk of dying,
even when they are HIV negative.6
The MaiMwana Project* is a development and research project combined in one
and aims to improve maternal and newborn care in the Mchinji District of Malawi.
The development part of the project works towards the improvement of health
service delivery across the district, through training of health workers, provision
of some basic equipment, and introduction of prevention of mother-to-child
transmission of HIV (PMTCT) services. The research component, on the other
hand, studies the impact of two community-based health promotion interventions
– women’s groups and volunteer infant feeding and care counsellors. This
community-based project study is funded by two grants from Saving Newborn
Lives (Save the Children, USA). Among the key objectives is to distil lessons from
this project in order to replicate the approach in other districts, through partners,
including the Ministry of Health in Malawi.
5 The highest elected
political position in a
barangay.
6 MaiMwana Project
Protocol.
18. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 18
Infant feeding and care counselling intervention
It all started with promoting exclusive breastfeeding among HIV infected mothers
to prevent the transmission from mother to child, through volunteer
counsellors from the villages. Today, the Volunteer MaiMwana Counsellors or
VMCs have gone beyond educating mothers about exclusive breastfeeding. They
even advise on weaning foods, family planning, birth preparedness, vaccinations,
proper nutrition and hygiene, as well as support mothers when they have
problems with breastfeeding.
“I can see the difference in my children,” shares Emma Kakhobwe, mother of two.
“Before I received any counselling, I just breastfeed my baby each time he cries
and I carry on doing other household tasks. Now I know that my baby should have
my full attention when breastfeeding. The volunteer counsellors also advised me
on how to handle my baby properly. Hence, my second born looks healthier and
does not get as sickly as my first born.”
The Volunteer MaiMwana Counsellors have been selected from the local
communities through recommendations from the village leaders. While being
identified by their traditional leaders for the programme is a source of pride for
these volunteers, the chosen VMCs said that they also welcomed the volunteering
opportunity to gain new knowledge and skills. The Volunteer MaiMwana
Counsellors are assigned to serve in their own villages to build on their credibility
in their areas and to address the issue of transport. Since the MaiMwana Project
works hand in hand with the District Health Office in Mchinji, the government has
committed its Health Surveillance Assistants to provide the supervising role for
the VMCs. MaiMwana provides the training, equipment, supplies and
expense allowance for the volunteers. MaiMwana staff also organise quarterly
meetings for all the volunteers, apart from individual consultations on a monthly
basis, to provide avenues for volunteers to share their experiences and learnings
in the field.
Volunteering makes the difference
Trained female facilitators manage the second community-based intervention of
the women’s groups. These facilitators guide the groups of women through the
following four-stage community mobilisation cycle:
• (Phase 1) identifying and prioritising local health problems and needs
• (Phase 2) planning local strategies
• (Phase 3) implementing these strategies
• (Phase 4) evaluating their successes in tackling their identified health problems
and needs.
Unlike the MaiMwana counsellors, MaiMwana is paying the women group
facilitators. This has led to some difficulties in getting some members of women’s
groups to actively participate in the community activities. Hence, MaiMwana is
now looking at the possibility of identifying capable volunteer facilitators among
the women’s groups since the communities more positively receive volunteers
than the paid facilitators. Many Malawian communities see volunteers as people
who give their services freely out of concern for others. This perception has
influenced the kind of cooperation that is generated from the people for this
community intervention of the Project.
Meanwhile, former volunteer counsellor turned MaiMwana staff Stella M’mango
proudly shared how her volunteering experience has enabled her to get paid work.
19. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 19
As she goes about her new role as an enumerator gathering baseline information,
Stella admits she still finds herself showing mothers how to breastfeed their
babies properly and advising them to take their sick children to health facilities for
proper care. Just like her new job, Stella takes pride in being a volunteer because
she was able to advise many women in her village.
Other volunteers mentioned how their husbands encourage them to be good
volunteers because, apart from being of service to their villages, they also see it
as a way for their wives to gain experience and be better qualified for future
employment opportunities. The VMCs also noted how the trainings and the other
benefits that they receive from MaiMwana effectively support them as volunteers.
Evaluating the interventions
As part of assessing the MaiMwana Project’s impact, selected cluster areas are
being evaluated against other areas that did not receive any of the interventions.
Although the MaiMwana Project is still finalising its data analysis, positive
changes in the behaviour of the Mchinji District health staff, such as a warmer
welcome for women from communities, as well as more women going to the
health centres, have already been observed.
Sustaining the work
The MaiMwana Project has been testing two low-cost health interventions, using
volunteers and women’s groups, which the Malawian government has been
supporting since 2003. Already, the Mchinji District Health Office has expressed
interest to continue the health volunteer programme since its Health Surveillance
Assistants are already involved in supervising the work of the volunteer
counsellors. The Volunteer MaiMwana Counsellors support the ongoing efforts of
the government health staff with their more personalised approach in dealing
with the communities through individual counselling. The District Health Office is
also confident in being able to source out and provide funding to support the
minimal expenses of the volunteers. The MaiMwana Team has yet to decide on
their next move come 2009. Given the success of the Project in Mchinji, MaiMwana
has been generating more international funding for scaling up and replication in
other Malawi districts.
*The MaiMwana Project in Mchinji District was inspired by the success of a
similar intervention to improve the health of pregnant mothers and their newborn
infants in the Makwanpur District in Nepal. To learn more about the Nepal
experience, visit www.wcf-uk.org or download
http://www.ich.ucl.ac.uk/ich/academicunits/cihd/Homepage;
http://www.health.org.uk/current_work/international_work/malawi.html for the
comprehensive report.
MALAWI ON MATERNAL AND CHILD HEALTH
Women group facilitators volunteering to mobilise communities
in improving maternal and child health
A Malawian woman who had just given birth almost died when a traditional birth
attendant (TBA) used the bark of sugarcane to cut her for lack of a razorblade.
The woman was eventually rushed to the nearest health centre because of non-
stop bleeding due to complications from infection.
20. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 20
Malawi’s Ministry of Health has recently changed its policy on TBAs involvement,
encouraging them to refer pregnant women to deliver at health facilities, while
penalising them if found conducting the deliveries. In the rural areas of Malawi,
about 67 per cent of birth deliveries are done at home. Having a delivery at home
often involves a traditional birth attendant, who has not received adequate
training to do the job. Doing so often leads to adverse maternal or perinatal
outcomes. Maternal mortality in Malawi has been reported as one of the highest
in the world, at 1,120 per 100,000. Infant mortality is also high, at 104 per 1,000.
Still the reality is that most Malawian women would rather risk their lives and
seek assistance from their trusted TBA when giving birth, than to receive poor
treatment from health staff in the health centres.
Using a ‘supply and demand’ approach
The Health Foundation Consortium (THFC) is composed of the Liverpool
Associates in Tropical Health, Liverpool School of Tropical Medicine, the Institute
of Healthcare Improvement, the Institute for Child Health and Women and
Children First; each has a distinctive role within the Consortium. THFC
started the implementation of key activities in the districts of Lilongwe, Kasungu
and Salima in June 2006, through close coordination with Malawi’s Ministry of
Health. Through a combined facility (supply) and community (demand) approach,
The Health Foundation Consortium aims to support the implementation of the
Malawi Road Map for accelerating the reduction of maternal and neonatal
mortality and morbidity.
‘Supply’ refers to the interventions being conducted on the side of health service
providers. This intervention does not deal directly with the volunteers, but rather
supports their work in promoting use of health facilities. In order to encourage
women to go to health centres, THFC saw the need to improve the quality of care
in the health centres through its Quality Improvement (QI) activities among
clinicians, midwives, nurses and other health workers. These QI activities include
workshops on topics such as development of clinical strategies to reduce
maternal and neonatal deaths, and effective support systems, e.g. inventory
systems to improve drugs and supply management and blood availability.
Mentoring and coaching activities, as well as exchange visits for mutual learning
and support among health service providers are also part of the QI interventions.
A hand washing campaign for health care workers, patients and
guardians, improved referral system for pregnant women and the development of
protocol for the management of pre-mature and low birth weight babies are just
some of the outcomes brought about by the QI activities. One village woman
shares that the most noticeable of all is the staff at her health centre being
friendlier towards them.
The ‘demand’, in this approach, represents the interventions being delivered in
the community level. This entails community sensitisation meetings, formation
and supervision of women’s groups and most importantly, working with women
volunteers to mobilise village women.
Working with traditional leaders
“We had to approach the different heads and leaders of the existing structures in
the communities and discuss how our programme would support their work in
building healthier communities, so we can get them to support our work.” Eric
Tsetekani, THFC Community Intervention Programme Officer shares how
21. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 21
important it is to work with the community and traditional leaders before
introducing the programme to the communities. The community leaders are
aware that many of the women in the villages are dying due to pregnancy related
causes and agreed on the need to educate the women so that such deaths could
be avoided in the future. The village headmen and other influential leaders in the
communities also assisted in identifying potential women volunteers after a
series of entry meetings to sensitise them on the health issues that the
programme hopes to address.
Women helping women
“Malawian women are not comfortable talking about issues relating to maternal
health, but there are better chances of making them speak out when with other
women. This is the reason why we deliberately sought out women as volunteers
for the programme.” Although they have women volunteers facilitating women’s
group discussions, there are certain meetings where men are invited to join so
women can feedback their shared issues to get their views and involvement. “If
you have men in the group from the first meeting, the women will just keep quiet
and let the men do all the talking. When it comes to maternal and child health
issues, the women surely know better than the Malawian men, and hence should
be doing most of the talking.” Eric explains.
Women Groups (WG) Facilitators are volunteers who have been identified by the
communities themselves, through the traditional leaders. Nonetheless, these
women volunteers had to meet the selection criteria and undergo the THFC
screening process that includes individual interviews. Preference is given to those
women who are married and have had children themselves. The WG volunteer
facilitators receive trainings on how to organise women’s groups and to facilitate
the meetings. They are also equipped with knowledge on maternal and neonatal
issues, including the THFC’s programme objectives. Apart from training the
volunteers, The Health Foundation Consortium also provides necessary
equipment and materials to facilitate the work of the women volunteers, including
an expense allowance, pushbikes, umbrellas and raincoats.
Every volunteer is expected to organise nine women’s groups and hold eight
meetings in each of these groups – each group has about 30 to 80 women
members from their assigned areas. Agendas for these meetings include probing
issues relating to maternal and child health issues and coming up with strategies
to address the identified issues. Promoting use of health facilities at certain
periods before, during and after giving birth, instead of going to a TBA, is one of
the volunteers’ main advocacies. Proper nutrition for the mother and child are
also discussed, including ways to access these healthy foods, such as through
gardening in their own backyards.
The Senior Women’s Group Supervisors (SWGS) are THFC staff and they oversee
the work of the volunteers. SWGS Victoria Sande said that while it is challenging
to attend to the varying demands of each volunteer, having the volunteers as
women’s group facilitators increases the chances of sustaining the impact of their
work in the communities. Because of the work of their volunteers, even the
daughter of a traditional birth attendant opted to give birth in a health facility
rather than at home.
22. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 22
Thirty-five-year-old Susan Mkhola has been a volunteer with The Health
Foundation Consortium for the past six months. She shared that her volunteering
has given her the opportunity to help other women in her community. More
importantly, it has also allowed her to gain knowledge on maternal and child
health issues that she herself could use as a woman and a mother of two.
PHILIPPINES ON SEXUAL AND REPRODUCTIVE HEALTH,
ADVOCATING FOR RIGHTS TO HEALTH CARE
MOTHERS volunteering to address sexual and reproductive
health issues, and advocating for health rights
The natural way is not good enough
Lourdes Osil has seven children, all born within 12 years. Warned by her
doctor of complications from repeated pregnancies, she started using
injectable contraceptives provided free at a local government health
centre. Eventually, the centre stopped providing contraceptives. Since
she could not afford to buy them and because natural family planning
methods have failed her, she had several unwanted pregnancies before she
found an NGO that provided counselling on different family planning methods.7
The Philippines, with a population of 84 million, is one of the fastest growing
populations in the world. About 70 per cent of Filipinos rely on the government for
family planning services. The Philippine government has prioritised the
promotion of the natural planning methods acceptable by the Roman
Catholic Church. Some city ordinances uphold natural family planning not just as
a method, but as a way of self-awareness in promoting the culture of life. To
discourage the use of artificial methods of contraception, such as condoms,
pills, intrauterine devices and surgical sterilisations, many local officials have
stopped allocating budget that used to allow community health centres to give
away free contraceptives.
Founding MOTHERS
A UNICEF study revealed Malabon as one of the poorest urban communities in
Metro Manila struggling with health issues brought about by lack of access to a
range of family planning methods. The research finding highlighted a wide range
of maternal and child health problems that are often associated with unplanned
pregnancies. This served as an entry point for Likhaan, an NGO engaged in
providing health care services to women in marginalised communities, to
establish their relationship with the mothers of Malabon. In coordination with the
government’s health centre, Likhaan’s first community activity was an
immunisation project, which was accompanied by health education sessions,
delivered through film showings, puppet shows and trainings. During the health
education activities, Likhaan managed to identify and invite selected members to
be the core group of a community-based organisation of volunteers. These core
group members were then trained and mentored by Likhaan so they could
continue the organising activities in their communities. Likhaan has also set up
another clinic to complement the services of the municipality’s health facilities.
The clinic provided the vital infrastructure for the delivery of the volunteers’ health
care services, as well as a meeting venue for these community volunteers.
Meanwhile, the inaccessibility of maternity clinics, found to be the major cause of
maternal deaths in the area, prompted Likhaan, in partnership with the Malabon
local government, to set up a lying-in clinic in a strategic location for 21
communities. Medical staff run the lying-in clinic with the assistance of the
community health volunteers.
7 Stella Gonzales,
Population- Philippines:
Manila Women to Fight Ban
on Contraceptives.
Challenging
Fundamentalisms,
http://www.whrnet.org/fun
damentalisms/docs/issue
-population-1007.html.
23. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 23
In 1992, a group of 12 mothers became MOTHERS. With guidance from Likhaan,
these Malabon mothers formed themselves to become a Mothers’ Organisation
for Total Health Education, Research and Services. Likhaan works with local
government health providers to implement health activities for 40,000 Filipinos in
Malabon, through the MOTHERS. The MOTHERS had to undergo intensive nine-
month health training with Likhaan, to lead in providing basic health services and
information in their communities. Today, these MOTHERS serve as advocates for
women’s rights to health care in local and national lobbying arenas, health
educators and community organisers. The MOTHERS also deliver health services,
such as immunisations for children and tetanus toxoid for women of reproductive
age, with support from the government health staff in the area. These health
volunteers said they continuously find ways to enhance their skills through
Likhaan’s trainings, to establish their credibility and earn the trust of their
communities. The MOTHERS also shared how their community volunteering has
helped build their confidence and gain self-affirmation, knowing that they are able
to do something to address the health issues in their communities. The
recognition that they receive from Likhaan and community members, including a
volunteer allowance, also validates their contribution.
A healthier community by mothers… and fathers
The nine-month health training delivered by Likhaan for the MOTHERS was
originally set for only six months. But the training schedule had to be adjusted to
the mothers’ activities, given their traditional roles at home. The husbands began
complaining and were initially unsupportive of their wives’ newfound role in their
communities. They saw the health training as time away from their wives’ families
and less time to attend to their husbands’ needs. Likhaan immediately began
organising activities to involve the men, ensuring joint discussions for men and
women, and providing mechanisms to accommodate childcare. These activities
did not only gain the support of the husbands, but also led to men’s involvement
in MOTHERS, doing exactly the same volunteering roles as the mothers or women
members. To date, MOTHERS has more than 1,200 members and has expanded
to include young men and women, and yes, the fathers.
An avenue for women’s creativity
The Filipino phrase linangan ng kababaihan suggests ‘an avenue for women’s
creativity’. Likhaan, short for Linangan ng Kababaihan, develops alternative
perspectives and approaches in health enabling marginalised women to be
autonomous social agents to look after their own health and be actively engaged
in improving society. This NGO’s approach to primary health care services is
twofold. First is the community-based programme that integrates basic health
care with community organising and education through trained community health
volunteers. The second involves setting up clinics that bring a medical team and
medical supplies to support their health programmes in the communities, with
assistance from the organised community volunteers. Likhaan has set up several
MOTHERS in many disadvantaged areas in Metro Manila. Likhaan guides and
supervises MOTHERS, as well as providing funding for the community-based
organisations’ operational expenses. A strong mentoring culture prevails where
every MOTHERS volunteer is supported along the way.
Likhaan also recruits organisers as staff in the communities where they work.
This enhances the sustainability of Likhaan’s initiatives. The Likhaan staff are part
of the communities they represent, hence the issues that the communities face
are their issues too. By linking people’s everyday concerns with national issues,
24. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 24
Likhaan is able to educate communities and empower them to assert their rights.
While Likhaan provides autonomy and independence to a number of community-
based organisations of volunteers like the MOTHERS, it also continues to provide
technical and financial assistance to them as its affiliates, whenever appropriate.8
A MOTHERS’ touch
Counselling is an integral part of the primary and reproductive health care
services being rendered by the MOTHERS. This helps people understand their
health situations, enabling them to make informed decisions. When the natural
way does not work, the fully equipped MOTHERS serve as the communities’ link
to proper information on alternative ways of family planning that incorporate
respect for the patients’ rights and quality care standards.
Likhaan’s capacity building versus direct resource supervision has made the
MOTHERS’ volunteers what they are today. With 15 years of community-
based health activities, the MOTHERS has also helped organise another volunteer
group of 220 young women, gay men and lesbians to expand their initiatives on
sexual and reproductive health and rights in other areas of the 21
communities. The MOTHERS and the youth group now have 55 trained leaders
among them to continue and sustain what Likhaan has started in the slum areas
of Malabon in 1992.
8 Maridel Icatlo, A field
study report on
MOTHERS, in partial
fulfilment to Women and
Development 221. First
Semester 2006-07.
25. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 25
This research has identified a number of key issues that programmes
may need to consider when planning, implementing or scaling up national
volunteering in health.
• Political will and working with Ministries of Health. In countries where there is
demonstrable political will VSO can play a role in mobilising and capitalising on
this support through its work with Ministry of Health partners. Where there is a
lack of political will, VSO may choose to focus on working with civil society
partners to influence Ministries of Health to help create an enabling environment
for volunteerism.
Involving a government’s Ministry or Department of Health is essential for a
sustainable and meaningful programme. VSO and its partners should seek to link
their work into the national health agenda. In practical terms this means having
an understanding of what the health priorities are, what resources are available
to deliver improvements in care and where there is scope for national volunteers
to make a contribution. Whether in terms of generating national policies to
institutionalise and gain wider support for local volunteers or sustaining local
health volunteering activities, partnership with the Ministry of Health is key.
The support of a Ministry of Health and its regional or district offices has a huge
impact on the work of health volunteers in the communities and hospitals. The
opportunities for a government health agency to continue managing the work of
health volunteers when a project ends are also much higher if they have been
significantly engaged in the health volunteer programme from the outset.
Just as in any partnership, it is recommended that agreements with Ministries of
Health are in writing and signed off. This is to ensure that the commitment of the
Ministry to support health volunteers lies with the government health institution
rather than with the Ministry of Health partners currently in position.
• Health volunteers complementing health professionals. While communities
should be an essential part of all health systems’ planning and delivery, in many
countries governments have left them to shoulder the burden of health care with
little funding or support from national health systems. VSO believes
strongly that the volunteering sector should be properly supported and developed
but it is also critical that efforts are made to expand the current health
workforce so that volunteers are not the only health workers in poor and
disadvantaged communities.
Any national volunteering health programme needs to ensure that it safeguards
against volunteers being deployed as cheap labour in roles that should be filled
by qualified health professionals. With the arising issues concerning use of para-
professionals, health volunteering activities must be designed in coordination
with the Ministry of Health to ensure that the role of health volunteers supports
existing health systems rather than undermining the services of health
institutions and professionals.
• Working with community leaders to gain support for national volunteering
health programmes. Community leaders can be highly influential in
sensitising villages about their health issues and the need for localised responses
through community volunteers. For example, asking the village headmen to assist
in identifying community volunteers for health activities gives them the
opportunity to support the programme, while increasing the likelihood of
recruiting the right volunteers.
KEY EMERGING ISSUES FOR NV IN HEALTH
26. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 26
Community leaders may be able to provide insight into the factors that are
preventing people from going to their health centres and can be essential
advocates in encouraging community members to access health services.
• Gender. Women often take the roles of care providers, yet are often the last to
receive care. When developing national volunteering health programmes, care
should therefore be taken to ensure that the health and well-being of volunteers
is balanced with the health gains of the programme itself.
Each national volunteering health programme should assess at which point men
should be included and promote their involvement in and joint responsibility for
community-based health programmes.
• Levels of risk for health volunteers. Volunteering for health exposes volunteers
to greater levels of risk. Health volunteer programmes should look after the
health and welfare of the volunteers. In order to minimise risks, adequate health
training prior to deployment should be given. This can be provided by a number of
different sources including health care staff or other service providers (NGOs).
The volunteers need to be linked to the health care system so that they remain
supported and up to date with health practices and continue to make a useful
contribution. Additional training, such as first aid and basic life support, for
unforeseen eventualities would also be useful to assist health volunteers in
delivering their expanding roles once out in the field.
In addition to appropriate health training, placement risk assessments, transport
provision, health kits, protective clothing and vaccines, where needed can further
minimise the risks. Health volunteer organisations should also have terms and
conditions that take into account the health hazards confronting their volunteers.
These policies would guide volunteer managers, as well as volunteers, on the
kind of available support in the advent of volunteers contacting disease or illness
as a result of volunteer activity.
• Health specific volunteer management resources. Health volunteers require
specialised training and so do the staff who manage these volunteers. References
that would particularly guide health organisations in setting up health volunteer
programmes or managing health volunteers are still limited. While a lot can be
learned from manuals for home-based care volunteering, there is a need to
modify these existing resources to make them more health-specific and useful to
health volunteer managers.
There is a role for VSO staff, volunteers and partners in developing and adapting
existing generic volunteer management materials to provide relevant and
appropriate health focused management guidelines.
27. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 27
This part of the report discusses ways of exploring, developing, integrating and
managing NV in health.
• Use of existing VSO NV and health resources. The National Volunteering Guide
for Programme Offices and the NV M&E guide provide comprehensive information
on approaches to national volunteering. VSO Mongolia’s successful experience of
developing NV in health can be used as a model of good practice. VSO’s position
paper on health and Health Goal updates provide guidance on our work in the
health sector. All of these documents are available on Vision and the health
Programme Development Adviser and Regional Volunteering Development
Advisers are an additional source of support.
• Exploring the use of the full range of the VSO ‘tool box’. Existing long or short
term health volunteers can be involved in exploring the possibilities of providing
NV support or setting up health volunteer programmes within their placements,
organisations or communities, as appropriate. Current health partners may have
links with other organisations and agencies that involve volunteers in their work
and as such present opportunities for networking and learning. An NV LINKS
study tour could be considered to find out more about models of health care
volunteering in other countries. Small grants could be used for seed funding to
support programme start up in a partner organisation or to enable national
exchange visits to learn about existing good practice in your own country.
• Creating capacity to develop NV health work. Several programme offices have
been successful in building their NV programme work with partners through the
use of short and long term volunteer development volunteers (VDVs). VDVs can be
placed among potential and strategic NV partners to identify ongoing health
programmes in the country that involve local or community volunteers, how it is
happening and what areas would benefit from VSO’s NV assistance. In some
programme offices, additional capacity has been created through the
appointment of dedicated national volunteering staff.
• Keeping NV work in health on the agenda. The VSO NV health programme or
plans to develop a programme can be promoted during in-country trainings,
partnership reviews, placement assessments, volunteer visits, workshops or
whenever the opportunity arises.
• Planning and Reviewing. Demonstrating evidence of VSO’s programme impact
and that of our partners is key to building a case to convince policy makers of the
value of NV work in health, where the outcomes are positive. Where evidence of
impact resulting from planning and review is limited, then this will necessitate
programme amendment or the need for further research. VSO’s own planning
and review guidelines and the NV M&E guidelines are essential tools that enable
programmes to measure outcomes and impact.
• Exploring opportunities for replication. The Mongolia case study demonstrates
that starting with a small-scale pilot in one province, working with an appropriate
partner, can lead to opportunities to scale-up across the country. In this instance
when the pilot impact assessment was completed and provided evidence of
improved community health as a result of the NV programme, it was easier to
secure funding and political support from the Ministry of Health to expand the
work. Linking NV partners to allow mutual support and learning, supported
through NV study tours, exchange visits and other learning fora has also been
proven effective in replicating NV efforts.
KEY CONSIDERATIONS FOR SCALING UP
VSO‘S NV WORK IN HEALTH
28. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 28
• Investigating opportunities for corporate partnership. VSO has significant
experience in developing global resource partnerships e.g. Astra Zeneca,
Accenture, Randstat that have resulted in increased supply of international
volunteers, programme funding, support in kind etc. A number of programme
offices are now beginning to explore the potential for corporate partnerships in
support of national volunteering, recognising the opportunities presented by the
increased global trend for corporate social responsibility agendas and employer
supported volunteering initiatives.
Jitolee and Bahaginan have already piloted employer supported volunteering
partnerships with corporates and this has led to some useful resources on how
to develop business partnership schemes under the NV programme. Volunteering
Development Advisers can be contacted for further information. Background
checks of potential corporate partners are recommended to ensure synergy with
VSO’s health objectives. Programme offices should check that the image,
background and practices of the private company would not be detrimental to
VSO’s work.
• Linking NV in health to NV work in other goal areas. Another way of scaling up
health NV initiatives is by exploring possible areas of collaboration with current
VSO partners in other programme areas where local volunteering is also
happening. Particularly when advocating for national policies to support the work
of local volunteers, others areas, such as HIV and AIDS, Disability, Education,
Secure Livelihoods or Participation and Governance, may present potential
opportunities for partnership and stronger multi-sectoral NV support.
29. APPENDIX 1: TIPS ON DEVELOPING
A HEALTH NV PROGRAMME
(FOR VSO PARTNERS)
The NV Guide for Programme Offices provides comprehensive information on
what kind of support for national volunteering can be expected and is available
from VSO. Meanwhile, this section offers some useful tips for VSO partners in
running their NV programmes and activities, which programme office staff or VSO
volunteers can refer to when dealing with NV stakeholders.
The case studies gathered from Malawi, Mongolia and the Philippines for this
report featured the interplay among different sectors and players in the field of
community health development. More importantly, the stories illustrated how
local groups of volunteers have taken community health challenges into their
hands and responded in their own ways, effectively. Engaging volunteers in
addressing health issues involves capacity building activities, as well as
considering the levels of risks that health volunteers face. It also requires
adoption of government and organisational policies that will be supportive of
health volunteer programme requirements. Other learning from the presented
case studies of various local volunteering initiatives can be summarised
as follows:
• Knowing the field. Counselling on family planning methods that work best for the
couple, lobbying for women’s rights to health care, talking about proper nutrition
and hygiene, giving patients that ‘human factor’ or personalised service,
conducting puppet shows on healthy lifestyle, doing community surveys for
baseline health information, or designing posters and flyers for health campaigns
– these are just a few of the many possibilities of addressing health issues in
different contexts with the most appropriate responses, given the available
resources. Be inspired by others’ NV work. In developing a health volunteer
programme, it is useful to know what kind of roles or activities health volunteers
can perform, given the health needs to be addressed and available resources of
the organisation and capacities of potential volunteers. There is a need to avoid
duplicating existing volunteering efforts and instead support ongoing NV
initiatives to strengthen impact. Being aware of what is already out there in order
to identify a niche that has been overlooked is important.
• Engaging and mobilising others. The key to getting the interest and support of
the stakeholders of a programme is seeking their participation as early as
possible in the planning phase of the volunteering initiative to promote ownership
of the programme, and build their commitment to it. Networking and collabo-
ration with representatives of relevant sectors is necessary in promoting a new
initiative and getting people to support it. Working closely with concerned
government agencies is particularly useful in advocating for national policies to
support the welfare of volunteers and promote the volunteerism movement. The
case studies have also demonstrated how efforts in involving men to address
women’s issues have produced better programme outcomes and more
sustainable impacts. At this stage, systems and procedures on how to monitor
and evaluate the impact of the health volunteer programme need to be discussed
and agreed on with the different programme stakeholders.
• Being creative. The featured case studies of various programmes, organisations
and sectors proved that there are limitless ways of effectively responding to health
challenges. However, designing a health volunteer programme that would
actually work calls for innovative thinking. The local volunteering initiatives in this
research may have similarities among them, in terms of the volunteer roles and
activities, and even when it comes to the health problems requiring common
LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 29
30. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 30
actions. Yet each has its own beginnings in specific contexts and each has its
unique way of responding to the need. Creativity is required in: a) identifying
approaches to be used in establishing relationships with the communities, health
partners and volunteers; b) setting up systems and procedures on working with
health partners and volunteers; and in c) designing effective health volunteer
activities and materials, such as puppet shows, dramas, videos, and publications
for health.
• Starting small, dreaming big. While taking small steps in starting up a health
volunteer programme, consider how volunteering activities can achieve greater
health impact through replication and scaling up.
• Making use of available resources. While a volunteering activity is often launched
to respond to an identified need, developing a health volunteer programme based
on the available skills and resources of an organisation, agency or community is
the most efficient approach. Given appropriate orientation and pre-deployment
trainings on health, disadvantaged women or mothers without formal education
can be the most effective volunteers for sexual and reproductive issues.
Interested volunteers without medical and health backgrounds can be recruited
for volunteering efforts that are non-health service delivery
related, such as developing information and educational materials for health
campaigns, conducting baseline health information surveys among
communities, or organising fundraising activities for health volunteer
programmes. It can be useful to link up with other health organisations or
agencies that are either implementing similar health programmes or promoting
volunteer training resources.
• Customising. Ways of targeting volunteers of every volunteer programme vary as
do strategies for attracting them and the criteria needed for their selection. The
manner of working with volunteers also depends on their profile. Hence, it is
important to design systems and procedures that would best suit the needs of a
health volunteer programme. In drafting recruitment strategies, developing
criteria and screening procedures, setting guidelines to monitor the volunteering,
as well as providing incentives or ways of recognising and motivating volunteers,
one must always keep in mind the kind of volunteers that need to be targeted
given the health volunteer roles, or the stakeholders to be dealt with. This goes
back to the health needs that the volunteer programme aims to address, which
then dictates the roles or job descriptions of health volunteers. The objectives of
the implementing organisation may also have a bearing on the systems and
guidelines in developing and managing a health volunteer programme.
• Appropriate matching of volunteers and placements. The careful matching of
volunteers with organisations not only improves volunteer motivation but also
organisational performance. Proper assessment of volunteers and host
organisations or communities also increases the chances of successful health
volunteering efforts.
• Equipping volunteers. Most case studies showed how crucial pre-deployment
and ongoing trainings of volunteers are in delivering good services to the
communities. Where the volunteer’s background is not health-based, appropriate
orientation for the volunteer’s new role in health can ensure that the volunteer is
properly prepared. Preparing the volunteers before the actual fieldwork is also a
way of ensuring that they will deal appropriately and sensitively with the people in
the communities.
31. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 31
Practical examples of how to equip volunteers could include:
1. Training volunteer counsellors on psycho-social counselling
2. Building the organisational and facilitation skills of women’s group facilitators
3. Ensuring volunteers dealing with TB patients have received proper
immunisation prior to deployment
4. Providing those who conduct home visits with the necessary means of transport,
health kits and protective clothing
5. Delivering training, such as first aid and basic life support, for unforeseen
eventualities to assist health volunteers in delivering their expanding roles once
out in the field.
Volunteer organisations and managers have the responsibility of providing the
required equipment and materials to help facilitate the volunteering service, while
looking after the welfare of the volunteers.
• Supervising, recognising and motivating volunteers. Volunteers have different
motivations, so regular monitoring through field supervisions, consultations and
meetings helps to clarify volunteer expectations and goals. These activities also
serve as monitoring tools and are an opportunity to identify learning needs. It is
recommended that opportunities for debriefing, counselling, mentoring and
coaching are available to health volunteers as part of volunteer supervision.
Many volunteers give their services out of their willingness to be of help to others
in need. Some people volunteer to improve their skills through the trainings and
experience that can be gained through volunteering. Whatever the motivations
may be, volunteers are not being paid for their services. The organisations
featured in this research demonstrated some examples of how to show their
appreciation of their volunteers. Whether through giving tokens of appreciation,
volunteer tributes, or accreditation of community work, incentives or other means
of recognition help sustain the commitment of volunteers and reaffirm the value
of the volunteers’ contribution. Given the different motivations of volunteers,
incentives or benefits should also be developed to suit the interests and needs of
volunteers. Volunteers who join to enhance their capacities might appreciate
getting more training, whereas professional health volunteers might find
volunteer tributes more gratifying.
Most importantly, volunteer programmes should understand the particular
challenges that face volunteers in the health sector. The organisation’s volunteer
policies or terms and conditions should take these health hazards into consid-
eration, by providing medical treatment for ill volunteers as a result of
volunteering activities or health insurance to ensure that the health of the
volunteers is also taken care of.
• Sensitising the community. Target communities need to understand how the
health programme can resolve health issues in their areas prior to the health
programme implementation and volunteer deployment. This often entails
supporting people in the communities to realise and identify their own health
problems. Where the community has been sensitised, volunteers are more likely
to receive local support and a positive response to their work.
Community sensitisation is sometimes part of the volunteers’ initial activities.
However, in cases where volunteers for the health programme are recruited from
the target communities, programme managers take the lead in conducting these
preliminary activities.
32. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 32
• Promoting the programme. Once the programme has been designed and
established there is an opportunity to start disseminating information about the
programme, highlighting the crucial role of volunteers in its implementation.
Ways of promoting the programme can range from use of the media to inform the
general public, or through community structures, such as churches and health
centres in order to reach a more specific audience. IEC materials and activities,
such as posters, flyers and puppet shows on health issues are also effective
marketing tools. Promoting the health volunteer programme increases chances
of replication and strengthens efforts of scaling up its health impact.
• Involving people with credibility and authority. Identifying and engaging with key
stakeholders and decision makers is an integral part of developing a programme
appropriate to the local context.
Apart from being sources of baseline information, village or traditional leaders
have often been proven as the most appropriate selectors of volunteers for
community health interventions. Village leaders do not only have knowledge of
their community, but they also have the authority to encourage volunteering. In
getting the village headmen on board, programme messaging during the
community sensitising activities could highlight how a volunteer health
programme can support community leaders in building healthier communities. In
approaching corporations, extra precautions must be taken to ensure that the
image, background and practices of the company will not be detrimental to the
volunteer programme.
• Adapting the programme. Despite careful planning and preparation, unforeseen
circumstances out in the field may have a dramatic impact on the volunteering
programme. Natural disasters, epidemics, and civil unrests may all affect a
volunteer health programme. The programme needs to be flexible enough to be
able to make the necessary adjustments, particularly in terms of adequately
preparing and protecting the volunteers. The approaches in implementing the
health volunteer programme must also be flexible to accommodate changes in
government health policies and laws, or to respond to community resistance.
Often, these unplanned changes can enhance the programme.
• Showcasing good work. Communicating a job well done is as important as doing
the job. By documenting the efforts of health volunteers, it becomes much easier
to promote its success. Without proper documentation, the progress or impact of
a good health volunteer programme is not easy to evaluate and share. Detailed
case studies of how local volunteers are addressing health issues in their
communities, or countries as a whole, can be widely disseminated to relevant
stakeholders.
Reports featuring success stories and good practices, whether in health or other
fields, are a means of showing how local volunteering can be an effective
mechanism to address health challenges. Documentation needs to focus not only
on the outcomes of the volunteering effort on the organisations, volunteers and
partners, but also take note of the changes that the volunteer programmes have
made on the health, or lives in general, of the people in the served communities.
33. Acquiring information for the case studies featured in this report entailed the
following activities:
1. Data gathering
• Library and desk reviews on national, local or community health volunteering
among various organisations, programmes, agencies in select areas/countries
where VSO operates
• Consultations and meetings (face-to-face, email and telephone) with research
stakeholders, as well as with key informants for nomination and referral of
models of effective national health volunteer programmes.
2. Criteria for selection of stakeholders and areas for case studies
While several NV case studies and impact stories across VSO’s goal areas have
been featured in various VSO publications and reports, the health area has been
under-represented. For this research, there has been a deliberate effort to search
for and feature case studies that are distinctively within the remit of VSO’s Health
Goal and across the cited four areas of priority. The need for diversity given the
different contexts in which VSO works has also been taken into consideration.
Thus, the attempt to gather cases in Asia and in Africa, whether within VSO or
non-VSO programmes.
With the ongoing discussions on promoting national volunteering and issues on
use of para-professionals, the criteria also ensured that the case studies
presented are supporting the countries’ existing health systems rather than
undermining the services of the health professionals.
To offer a relevant and useful range of local health volunteering initiatives, the
following criteria guided the selection of case studies:
a) Organisational/programme profile
Either VSO or non-VSO programme focusing on the cited priority health areas,
and is being delivered/achieved through national volunteering, including those
supported through VSO volunteers
b) Performance
With good track record, sustainable and presents opportunities to scale up the
impact
c) Accessibility and availability of data
Must have sufficient data to feature good practices, as well as to assess the
performance and impact of the national health volunteer programme for the past
years of operation
d) Diversity
Case studies must offer a diverse range of national health volunteering initiatives
in different sectors, regions or countries, specifically in Asia and Africa, and in the
four priority areas within the Health Goal.
3. Methods for case studies
Given the two-month duration of this research, the actual field visits to volunteer
placements and activities were limited to the Philippines and Malawi. For the rest
of the case studies, the researcher had to rely on library and desk research, as
well as telephone and email consultations with research stakeholders – local
volunteers, partners, volunteer organisations, volunteer managers, beneficiaries
and VSO programme staff, where relevant.
APPENDIX 2: METHODOLOGY AND SCOPE
LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 33
34. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 34
General:
Fisher, Wendy. Programme Development Officer for Health, Programme Learning
& Advocacy
Strategic Position Paper for VSO’s Health Goal, VSO International, London UK,
January 2007.
Holmes, Liz. Senior Management Team Health Goal Update, VSO International,
London: UK, December 5, 2007.
Malawi:
• MaiMwana Project
Interviews
Chapota, Hilda. Senior Officer, Health Service Strengthening, MaiMwana Project,
March 19, 2008.
Jare, Sipho. Acting Manager/ Senior Officer, Monitoring and Evaluation,
MaiMwana Project, March 19, 2008.
Kadewere, Alinafe. Volunteer Counsellor, Zone 13 Mchinji District, MaiMwana
Project, March 19, 2008.
Kakhobwe, Emma. Beneficiary, Zone 13 Mchinji District, MaiMwana Project,
March 19, 2008.
Lewycka, Sonia. Technical Adviser/ Research Fellow, Institute of Child Health,
MaiMwana Project, March 19, 2008.
M’mango, Stella. Women Enumerator (former VMC), MaiMwana Project,
March 19, 2008.
Rosato, Mikey. Technical Adviser/ Institute of Child Health Research Fellow,
MaiMwana Project, March 19, 2008.
Yainja, Esther. Health Service Strengthening Officer, MaiMwana Project,
March 19, 2008.
Documents
MaiMwana Project Protocol and Brochure
Websites
“Effect of a participatory intervention with women’s groups on birth outcomes in
Nepal: cluster-randomised controlled trial.”
http://www.ich.ucl.ac.uk/ich/academicunits/cihd/Homepage
“Women and Child First.” http://www.wcf-uk.org
• The Health Foundation Consortium
Interviews
Kamphasa, Jeremiah. Supervisor, THFC Senior Women’s Group, March 17, 2008.
Mkhola, Susan. Facilitator Volunteer, THFC Women’s Group, March 18, 2008.
Mvuman, Mwandida. Coordinator, THFC Lilongwe District, March 17, 2008.
Sande, Victoria. Supervisor, THFC Senior Women’s Group, March 17, 2008.
Tsetekani, Eric. Officer, THFC Community Intervention Programme,
March 17-18 and 20, 2008.
Group Discussions
Kasungu Village. Meeting with the Women and Traditional Leaders,
March 18, 2008.
Salima Village. Meeting with the Women and Traditional Leaders,
March 20, 2008.
REFERENCES
35. LOCAL VOLUNTEERING RESPONSES TO HEALTH CARE CHALLENGES 35
Documents
The Health Foundation Consortium Implementation Plan, Lilongwe: Malawi,
February 2008.
The Health Foundation Consortium Monthly Reports, Lilongwe: Malawi,
January-September 2007.
Mongolia:
• VSO Mongolia
Consultations (Email)
Benablo, Glenn. Volunteer, VSO Darkhan Health Department, Mongolia.
Pureviin, Amar. Manager, VSO Mongolia NV Programme, Mongolia.
Documents
Mongolia Study Tour Report, April 3-17, 2006.
NV Impact Assessment Presentation, March 2008.
Philippines:
• Barangay Health Workers
Interviews
Boco, Loida. Barangay Health Worker Beneficiary, University of the Philippines
Campus, March 4, 2008.
Gravides, Isabelita. Barangay Captain, Barangay University of the Philippines
Campus, March 3 and 4, 2008.
Nose, Flory. Barangay Health Worker, University of the Philippines Campus,
March 4, 2008.
Vergara, Jose Miguel, MD. DOH Director IV (1992-1996), Quezon City,
Philippines, February 5, 2008.
Publications
Barangay Documents: Primer on the Barangay Local Government and Community
Development, Quezon City: Philippines, 1977.
Republic of the Philippines’ Department of Health, Republic Act 7883: Barangay
Health Workers Benefits and Incentives Act of 1995, Manila: Philippines.
South-to-South Study Program on Health: A Study of Alternative Health Case
Programs in the Philippines and India, National Ecumenical Health Concerns,
Central National Council for Churches in the Philippines, Quezon City:
Philippines, 1987.
Gustin, Venerando. The Barangay: The Basic Political Unit, Central Law Book
Publishing, Phoenix Press, Quezon City: Philippines, 1992.
Lacuesta, Marlina, etal. “A Diagnostic Study on the Implementation of DOH
Health Volunteer Workers Program”, Asia and Near East Operations Research
and Technical Assistance Programme, October 1994.
Solon, Floretino S., ed. Barangay Health Aide’s Field Manual, Manila: Philippines.
Tayag, Josefina, ed. Structure, Process and Outcome of Decision-making in Health,
Department of Health-Local Government Assistance and Monitoring Service and
College of Arts and Sciences, University of the Philippines-Manila, Manila:
Philippines, 1999.
Veneracion, Cynthia, etal. Initiatives and strategies for Community Health
Development: Case Studies of Four Philippines Rural Barangays, Institute for
Philippines Culture, Ateneo de Manila University, Quezon City: Philippines, 1993.
Websites
“Republic Act 7883, Barangay Health Workers’ Benefit Incentives Act of 1995,
Republic of the Philippines Congress.” http://www.doh.gov.ph/ra/ra7883
